Monday, 1 September 2014

Largest Study to Date: Transgender Hormone Treatment Safe

Largest Study to Date: Transgender Hormone Treatment Safe

Cross-sex hormone treatment of transgender adults leads to very few long-term side effects, according to the authors of the largest study to date to examine this issue.
More than 2000 patients from 15 US and European centers participated in the retrospective study, called Comorbidity and Side Effects of Cross-Sex Hormone Treatment in Transsexual Subjects, and nearly 1600 received at least 1 year of follow-up, the authors reported.
"Our results are very reassuring," principal investigator Henk Asscheman, MD, PhD, who heads HAJAP, his clinical research company in Amsterdam, the Netherlands, told Medscape Medical News. "There are mostly minor side effects and no new [adverse events] observed in this large population."
Speaking at ICE/ENDO 2014 last week, where he presented the initial results of the research, Dr. Asscheman said the data confirm findings from smaller studies published in the past decade.
"The take-home message," he said, "is that when using the guidelines from the Endocrine Society ["Endocrine Treatment of Transsexual Persons"], you are not going to see a lot of comorbidities with cross-sex hormone treatment."
 

Thursday, 14 August 2014

Why blogging has been light recently

Woman burnt in Downer house fire June 2, 2014

A 56-year-old woman has suffered serious burns following a kitchen fire on Burn Street in Downer.
...
The woman was treated by intensive care paramedics at the scene of the fire and then transported to the Canberra Hospital.
The ESA spokeswoman said she was in a stable condition.

My face was never my fortune, and a few minor scars on the forehead won't make any difference to that. I lost all the skin on my face, but it grew back, and I still have lips, eyelids, nose etc, and looking not very different from before. A few patches on my arms were 3rd degree, but so small no skin grafts were needed.

I just get a bit cold now, much of my dermis on face and arms was destroyed, so there's less subcutaneous fat now, and this will take a year or two to get better.

No damage to lungs or airways. So no real long-term or life-changing effects.

It's taken me a few months to feel OK with blogging it though. I always was terrified of fire, and to be put in a position of having to stay and fight rather than being able to flee was traumatic. Then being warned by the nurses in the resuscitation unit of Canberra Hospital not to look in the mirror was, well, I thought that only happened in the movies.

But it was only for a short while that I looked like a Hiroshima survivor. Now back to normal, or near enough.

Sunday, 6 July 2014

Two sides. Same coin.

Sex differences in the structural connectome of the human brain

Sex differences in the structural connectome of the human brain Ingalhalikar et al PNAS ; published ahead of print December 2, 2013

Sex differences in human behavior show adaptive complementarity: Males have better motor and spatial abilities, whereas females have superior memory and social cognition skills. Studies also show sex differences in human brains but do not explain this complementarity. In this work, we modeled the structural connectome using diffusion tensor imaging in a sample of 949 youths (aged 8–22 y, 428 males and 521 females) and discovered unique sex differences in brain connectivity during the course of development. Connection-wise statistical analysis, as well as analysis of regional and global network measures, presented a comprehensive description of network characteristics. In all supratentorial regions, males had greater within-hemispheric connectivity, as well as enhanced modularity and transitivity, whereas between-hemispheric connectivity and cross-module participation predominated in females. However, this effect was reversed in the cerebellar connections. Analysis of these changes developmentally demonstrated differences in trajectory between males and females mainly in adolescence and in adulthood. Overall, the results suggest that male brains are structured to facilitate connectivity between perception and coordinated action, whereas female brains are designed to facilitate communication between analytical and intuitive processing modes. 

Wednesday, 2 July 2014

If you can read this....

Then consider yourself lucky. Some can't.


http://aebrain.blogspot.com

ISP Result Last check on Last blocked on
AAISP ok 2014-07-02 12:20:06 No record of prior block
BT blocked 2014-07-02 12:20:06 2014-07-02 12:20:06
EE ok 2014-07-02 12:20:07 No record of prior block
Plusnet ok 2014-07-02 12:20:06 No record of prior block
Sky ok 2014-07-02 12:20:06 No record of prior block
TalkTalk blocked 2014-07-02 12:20:06 2014-07-02 12:20:06
VirginMedia ok 2014-07-02 12:20:06 No record of prior block

Report via https://www.blocked.org.uk/

The (UK) government is promoting filters to prevent children and young people from seeing content that is supposed to be for over 18s. This includes pornography and sites that talk about alcohol, smoking, anorexia and hate speech.

In practice, filters block many sites that are not harmful to children. Sometimes, they are blocked by mistake. Sometimes, they are blocked deliberately. For example, many blogs and forums are blocked by default.

The Blocked! website lets you check whether a site has been blocked by these filters. The tool is free but you can support the project by joining ORG, making a donation or becoming a technical volunteer.

Sunday, 29 June 2014

A Matter of Medical Education

Key points to note:
  • Transgender medicine is rarely taught in medical curricula
  • Prior to the unit, 38% of students self-reported anticipated discomfort with caring for transgender patients.
  • Even in an endocrinology unit, prior to adding this subject, 5% of students reported that the treatment was not a part of conventional medicine.
1 in 20 new endocrinologists are completely clueless without unusual training, and they're supposed to be the specialists! Fortunately, it doesn't take much to fill them in.

A simple curriculum content change increased medical student comfort with transgender medicine. Safer JD1, Pearce EN. Endocr Pract. 2013 Jul-Aug;19(4):633-7

Abstract

OBJECTIVE:

A barrier to safe therapy for transgender patients is lack of access to care. Because transgender medicine is rarely taught in medical curricula, few physicians are comfortable with the treatment of transgender conditions. Our objective was to demonstrate that a simple content change in a medical school curriculum would increase students' willingness to care for transgender patients.

METHODS:

Curriculum content was added to the endocrinology unit of the Boston University second-year pathophysiology course regarding rigidity of gender identity, treatment regimens, and monitoring requirements. All medical students received an online, anonymous questionnaire 1 month prior to and 1 month after receiving the transgender teaching. The questionnaire asked about predicted comfort using hormones to treat transgender individuals. Shifts in the views of the second-year students were compared with views of students not exposed to the curriculum change.

RESULTS:

Prior to the unit, 38% of students self-reported anticipated discomfort with caring for transgender patients. In addition, 5% of students reported that the treatment was not a part of conventional medicine. Students in the second-year class were no different than other students. Subsequent to the teaching unit, the second-year students reported a 67% drop in discomfort with providing transgender care (P<.001), and no second-year students reported the opinion that treatment was not a part of conventional medicine.

CONCLUSION:

A simple change in the content of the second-year medical school curriculum significantly increased students' self-reported willingness to care for transgender patients.

Wednesday, 25 June 2014

Seen on the web

I wish I'd written it. By jnail7
However, it seems clear that you are attempting to follow a Socratic method in engaging in an argument for Biological essentialism. Here is an example of how to accomplish your goal in a form that is more functional to a comment thread than point by point posting.
1) Humans develop from a single cell egg to a complex multicellular organism.
2) The form of human includes various cellular expressions that create organs, tissues, etc. that provide specific functions for survivability and perpetuation of the species, which are universal across the species in general, though may differ in some way individually.
3) One outcome in development from the egg is sexual dimorphism, when the developing fetus's cells organize into a pattern that is labelled male or female, also known as sex differentiation. This differentiation continues at various stages throughout an individual's life.
4) Sex differentiation not only refers to the physical development of the observable body, but also requires that the brain physically in preparation to manage the biological needs (endocrine) for the developing sex and to process sensory input for the body.
5) Development from a single cell to a complex human is far from a perfect process, as evidenced by the variations that are completely benign to those that result in the death of the developing fetus.
6) Variations in the developmental process do result in incomplete or even mismatched sex characteristics that would have been assumed by karyotyping (which is rarely done).
7) Since evidence is easy to obtain showing variation in the sex based development of physical bodies, and evidence also shows variation in development in physical brains, it is not without reason to expect the potential of a variation where the brain develops according to the needs of one sex and the body develops the opposite.
8) Current research is mounting evidence for #7.
So if 7 is true, how would we expect this to manifest from observable behavior?
1) Given that we are culturally reinforced with expected gender norms that encourage some means of expressing one's sex through gender expression (think clothes, behaviors/mannerism, occupational choices, etc.) our cultural understanding of sex is limited by our vocabulary of gender and how we perceive it in others.
2) Instinctively, infants have a drive to mimic behavior that they observe, thus enabling them to learn. However, children demonstrate a preference for mimicking behavior that they identify with. This is where many children start learning gender roles as expressed in their culture.
3) Those whose brain sex matches their body sex have no trouble meeting societal expectations, nor conceive of any issue concerning their own anatomy.
4) Those whose brain sex does not match their body sex have no frame of reference to describe it. Early attempts to mimic the behaviors of the identified sex are likely met with punishment/shaming. For most, this shuts them down and they learn to hide their issue. With no means to discuss what they cannot describe, they reach for the next closest thing, which is the symbol of their desired sex as expressed by those in the opposite gender. Clothes, behavior, etc. become symbolic to the point of becoming the only language available to express/explore their inner identity.
5) worse are those whose brain did not develop completely male or female and they are stuck in some artificial limbo dictated by societal gender norms. Regardless, such people are still human beings, no less than any other. Many wish peace with the conflicts they experience internally. Many have also had to hide because they cannot articulate or communicate their pain in a way that our culture finds meaningful. Some succumb to the pain and take their life.
In the end, whether you believe that transgender is a real physical condition or something simply "in one's head", it does not matter. There is no excuse for denying an individual their humanity or to dismiss them as an "other". Furthermore, look at your view points now and ask yourself, if this is proved to be something physical and "real", what have you accomplished? On the flip side, if it is proved to me to be purely behavioral/cognitive (ie. not physically interlinked from a developmental standpoint), then at least my actions were done with in keeping with the current science and medicine available and my view points subject to reinterpretation based on new evidence.

Saturday, 31 May 2014

DAB No. 2576 - NCD 140 3 Transsexual Surgery

DAB No. 2576 - NCD 140 3 Transsexual Surgery by EvanMcSan

A follow-up to a previous post on the issue.

Reading between the lines, there are some very damning comments about how the original decision was arrived at - such as the dismissal of studies with follow-up over many years as "not long-term" without defining what "long-term" meant; or the citing of treatment as "controversial", not in a scientific sense, but a political one.

We note that in addition to stating that transsexual surgery was experimental, the NCD and the 1981 report stated that transsexual surgery was "controversial." NCD Record at 18(1981 report stating that "[ o ]ver and above the medical and scientific issues, it would also appear that transsexual surgery is controversial in our society"). The AP and the new evidence dispute the relevance of this statement. The AP objected that this point relies on two "polemics" that are "are either completely unscientific or fall far outside the scientific mainstream," and Dr. Ettner stated that the views expressed therein "fall far outside the mainstream psychological, psychiatric, and medical professional consensus and call into question the objective reasonableness of the NCD. AP Statement at 15-16; Ettner Supp. Decl. at,;,; 17-18. CMS has not asserted that the Board's decision may be based on factors over and above the medical and scientific issues involved. Considerations of social acceptability (or nonacceptability) of medical procedures appear on their face to be antithetical to Medicare's medical necessity inquiry, which is based in science, and such considerations do not enter into our decision that the NCD is not valid.

One of those appears in this post, 50,000 deaths. I'll try to find the source of the other one, a religious tract. Though the first one is a religious tract too, or at least, ideological.
Neither Religion nor Ideology have any place in medicine, or indeed, science generally.